subject_line
Prosthetic Symposium | Successful Rehabilitation of the Lower Limb Amputee
Instructor (Full Name, Credentials):
Profession Type (please choose all that apply):
*
Physical Therapist
Occupational Therapist
Case Manager
Social Worker
Physician
Nurse
Other, please specify
Other Profession Type:
Location (Site Name, City and State):
*
Site Name, City, State
Date:
*
+
Course Assessment
*
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Scientific evidence was provided to substantiate course content
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Information presented will be useful in my healthcare career
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Information was presented free from commercial bias
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Technology was user-friendly & appropriate to support participant learning (if applicable)
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Quality of the physical facilities was conducive to learning
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Speaker Assessment
*
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
The speaker was professional and knowledgeable on course content
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
The speaker was qualified and held my interest
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
The speaker was timely and organized
Strongly Agree
Agree
Undecided or N/A
Disagree
Strongly Disagree
Course Objectives Assessment
The course has met the below learning objectives, and I am now able to:
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Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Understand how to practice appropriate prosthetic management of bilateral transfemoral amputees and management of congenital limb deficiencies
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Identify appropriate socket fit and assessment techniques that will have the greatest benefit for the prosthetic patient
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Evaluate common prosthetic gait anomalies
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Identify their own patient's ability or potential for ambulation with variable cadence
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Compare and contrast post treatment assessments and therapies experienced by the amputee
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Explain treatment goals based on testimony of the course speaker
Strongly Agree
Agree
Undecided
Disagree
Strongly Disagree
Self-Assessment Tool: How confident were you in your knowledge?
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Very Confident
Fairly Confident
Somewhat Confident
Not Confident
Before the course?
Very Confident
Fairly Confident
Somewhat Confident
Not Confident
After the course?
Very Confident
Fairly Confident
Somewhat Confident
Not Confident
How likely would you be to recommend Hanger Clinic’s Continuing Education Program to a colleague or friend?
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10 - Extremely Likely
9
8
7
6
5
4
3
2
1
0 - Not at all Likely
Why?
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What were the key takeaways from this course that you will use as a health care professional?
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Suggestions for improvement?
Additional topics we should offer in the future?